Low-Attenuation Noncalcified Plaque on Coronary Computed Tomography Angiography Predicts Myocardial Infarction: Results From the Multicenter SCOT-HEART Trial (Scottish Computed Tomography of the HEART).

Abstract:

BACKGROUND:The future risk of myocardial infarction is commonly assessed using cardiovascular risk scores, coronary artery calcium score, or coronary artery stenosis severity. We assessed whether noncalcified low-attenuation plaque burden on coronary CT angiography (CCTA) might be a better predictor of the future risk of myocardial infarction. METHODS:In a post hoc analysis of a multicenter randomized controlled trial of CCTA in patients with stable chest pain, we investigated the association between the future risk of fatal or nonfatal myocardial infarction and low-attenuation plaque burden (% plaque to vessel volume), cardiovascular risk score, coronary artery calcium score or obstructive coronary artery stenoses. RESULTS:In 1769 patients (56% male; 58±10 years) followed up for a median 4.7 (interquartile interval, 4.0-5.7) years, low-attenuation plaque burden correlated weakly with cardiovascular risk score (r=0.34; P<0.001), strongly with coronary artery calcium score (r=0.62; P<0.001), and very strongly with the severity of luminal coronary stenosis (area stenosis, r=0.83; P<0.001). Low-attenuation plaque burden (7.5% [4.8-9.2] versus 4.1% [0-6.8]; P<0.001), coronary artery calcium score (336 [62-1064] versus 19 [0-217] Agatston units; P<0.001), and the presence of obstructive coronary artery disease (54% versus 25%; P<0.001) were all higher in the 41 patients who had fatal or nonfatal myocardial infarction. Low-attenuation plaque burden was the strongest predictor of myocardial infarction (adjusted hazard ratio, 1.60 (95% CI, 1.10-2.34) per doubling; P=0.014), irrespective of cardiovascular risk score, coronary artery calcium score, or coronary artery area stenosis. Patients with low-attenuation plaque burden greater than 4% were nearly 5 times more likely to have subsequent myocardial infarction (hazard ratio, 4.65; 95% CI, 2.06-10.5; P<0.001). CONCLUSIONS:In patients presenting with stable chest pain, low-attenuation plaque burden is the strongest predictor of fatal or nonfatal myocardial infarction. These findings challenge the current perception of the supremacy of current classical risk predictors for myocardial infarction, including stenosis severity. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01149590.

journal_name

Circulation

journal_title

Circulation

authors

Williams MC,Kwiecinski J,Doris M,McElhinney P,D'Souza MS,Cadet S,Adamson PD,Moss AJ,Alam S,Hunter A,Shah ASV,Mills NL,Pawade T,Wang C,Weir McCall J,Bonnici-Mallia M,Murrills C,Roditi G,van Beek EJR,Shaw LJ,Nicol E

doi

10.1161/CIRCULATIONAHA.119.044720

subject

Has Abstract

pub_date

2020-05-05 00:00:00

pages

1452-1462

issue

18

eissn

0009-7322

issn

1524-4539

journal_volume

141

pub_type

杂志文章
  • Chest compression rates during cardiopulmonary resuscitation are suboptimal: a prospective study during in-hospital cardiac arrest.

    abstract:BACKGROUND:Recent data highlight a vital link between well-performed cardiopulmonary resuscitation (CPR) and survival after cardiac arrest; however, the quality of CPR as actually performed by trained healthcare providers is largely unknown. We sought to measure in-hospital chest compression rates and to determine comp...

    journal_title:Circulation

    pub_type: 杂志文章,多中心研究

    doi:10.1161/01.CIR.0000153811.84257.59

    authors: Abella BS,Sandbo N,Vassilatos P,Alvarado JP,O'Hearn N,Wigder HN,Hoffman P,Tynus K,Vanden Hoek TL,Becker LB

    更新日期:2005-02-01 00:00:00

  • Impaired L-arginine transport and endothelial function in hypertensive and genetically predisposed normotensive subjects.

    abstract:BACKGROUND:Impaired endothelium-dependent NO-mediated vasodilation is a key feature of essential hypertension and may precede the increase in blood pressure. We investigated whether transport of the NO precursor L-arginine is related to decreased endothelial function. METHODS AND RESULTS:Radiotracer kinetics ([3H]L-ar...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000149748.79945.52

    authors: Schlaich MP,Parnell MM,Ahlers BA,Finch S,Marshall T,Zhang WZ,Kaye DM

    更新日期:2004-12-14 00:00:00

  • Mitral anulus motion. Relation to pulmonary venous and transmitral flows in normal subjects and in patients with dilated cardiomyopathy.

    abstract::The dynamics between mitral anulus motion, and, thus, motion of the base of the heart, and filling of the left atrium and ventricle were studied by Doppler echocardiography in 12 normal subjects and 28 patients with dilated cardiomyopathy. The normal motion of the mitral anulus is associated with two phases of inflow ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.78.3.621

    authors: Keren G,Sonnenblick EH,LeJemtel TH

    更新日期:1988-09-01 00:00:00

  • Baroreflex sensitivity, clinical correlates, and cardiovascular mortality among patients with a first myocardial infarction. A prospective study.

    abstract::Experimental studies have shown that among dogs with a healed myocardial infarction, depressed baroreflex sensitivity (BRS) identifies a subgroup at higher risk for sudden death. We have examined the relation among BRS, several clinical cardiovascular variables, and subsequent mortality in 78 patients below the age of...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.78.4.816

    authors: La Rovere MT,Specchia G,Mortara A,Schwartz PJ

    更新日期:1988-10-01 00:00:00

  • Characteristics of coronary smooth muscle cells and adventitial fibroblasts.

    abstract:BACKGROUND:Recent findings suggesting the involvement of adventitial cells in coronary repair have raised questions regarding the phenotypic "plasticity" of medial smooth muscle cells (SMCs). Accordingly, the aims of the present study were to examine the characteristics of coronary medial and adventitial cells and to c...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.101.5.524

    authors: Patel S,Shi Y,Niculescu R,Chung EH,Martin JL,Zalewski A

    更新日期:2000-02-08 00:00:00

  • Long-Term Survival and Freedom From Reintervention After Off-Pump Coronary Artery Bypass Grafting: A Propensity-Matched Study.

    abstract:BACKGROUND:The long-term outcomes of off-pump coronary artery bypass grafting (CABG) are the subject of speculation. Our institution has >15 years of experience performing CABG both off-pump (OPCAB) and on cardiopulmonary bypass (CPB). Our null hypothesis was that there would be no difference in a long-term composite o...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.116.021933

    authors: Kirmani BH,Holmes MV,Muir AD

    更新日期:2016-10-25 00:00:00

  • Extensive primary repair of the thoracic aorta in acute type a aortic dissection by means of ascending aorta replacement combined with open placement of triple-branched stent graft: early results.

    abstract:BACKGROUND:To simplify extensive primary repair of the thoracic aorta in acute type A aortic dissection, we developed the open triple-branched stent graft placement technique. The early results of this new technique are reported. METHODS AND RESULTS:Between June 2008 and November 2009, 30 patients with acute Stanford ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.110.946012

    authors: Chen LW,Dai XF,Lu L,Zhang GC,Cao H

    更新日期:2010-10-05 00:00:00

  • Sustained improvement after combined anterior mitral leaflet extension and myectomy in hypertrophic obstructive cardiomyopathy.

    abstract:BACKGROUND:Mitral leaflet extension (MLE) combined with septal myectomy is a new surgical approach to treat hypertrophic obstructive cardiomyopathy (HOCM) and an enlarged mitral leaflet area. The study presents the long-term clinical results and outcome of this technique. METHODS AND RESULTS:MLE entails grafting a glu...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章

    doi:10.1161/01.CIR.0000092912.57140.14

    authors: van der Lee C,Kofflard MJ,van Herwerden LA,Vletter WB,ten Cate FJ

    更新日期:2003-10-28 00:00:00

  • Instant power spectrum analysis of heart rate variability during orthostatic tilt using a time-/frequency-domain method.

    abstract:BACKGROUND:Spectral analysis of heart rate (HR) variability (HRV) requires, as a rule, some level of stationarity and, as a result, is inadequate to quantify biological transients. A time-/frequency-domain method (TF) was developed to obtain an instant spectral power (SP) of HRV during tilt. METHODS AND RESULTS:HR was...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章

    doi:10.1161/01.cir.96.10.3521

    authors: Jasson S,Médigue C,Maison-Blanche P,Montano N,Meyer L,Vermeiren C,Mansier P,Coumel P,Malliani A,Swynghedauw B

    更新日期:1997-11-18 00:00:00

  • Late dysrhythmias and disturbances of conduction following Mustard operation for complete transposition of the great arteries.

    abstract::Between 1964 and 1971, 49 patients were discharged from hospital following atrial baffle repair for transposition of the great arteries. Electrocardiograms of 47 of these patients were available for review seven months to eight and a half years (average 31 months) after operation. Of the 46 patients in sinus rhythm pr...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.53.3.519

    authors: Clarkson PM,Barratt-Boyles BG,Neutze JM

    更新日期:1976-03-01 00:00:00

  • Heat-shock protein 60-reactive CD4+CD28null T cells in patients with acute coronary syndromes.

    abstract:BACKGROUND:CD4+CD28null T cells are present in increased numbers in the peripheral blood of patients with acute coronary syndrome (ACS) compared with patients with chronic stable angina (CSA). The triggers of activation and expansion of these cells to date remain unclear. METHODS AND RESULTS:Twenty-one patients with A...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000118476.29352.2A

    authors: Zal B,Kaski JC,Arno G,Akiyu JP,Xu Q,Cole D,Whelan M,Russell N,Madrigal JA,Dodi IA,Baboonian C

    更新日期:2004-03-16 00:00:00

  • Ultrasonic tissue characterization: detection of acute myocardial ischemia in dogs.

    abstract::Ultrasonic tissue characterization is a new area of investigation in the field of cardiac ultrasound. The amplitude and frequency of the ultrasound signal are normally altered as the signal penetrates through tissue. It is assumed that the amplitude distribution and frequency shift of diseased or edematous tissue are ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.72.1.193

    authors: Schnittger I,Vieli A,Heiserman JE,Director BA,Billingham ME,Ellis SG,Kernoff RS,Takamoto T,Popp RL

    更新日期:1985-07-01 00:00:00

  • Decreased activity of the L-arginine-nitric oxide metabolic pathway in patients with congestive heart failure.

    abstract:BACKGROUND:Impaired endothelium-dependent, nitric oxide (NO)-mediated vasodilation may contribute to increased vasomotor tone in patients with heart failure. Whether decreased endothelium-dependent, NO-mediated vasodilation in patients with heart failure is due to decreased synthesis or increased degradation of NO is u...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.99.16.2113

    authors: Katz SD,Khan T,Zeballos GA,Mathew L,Potharlanka P,Knecht M,Whelan J

    更新日期:1999-04-27 00:00:00

  • Reverse remodeling of sinus node function after catheter ablation of atrial fibrillation in patients with prolonged sinus pauses.

    abstract:BACKGROUND:Symptomatic prolonged sinus pauses on termination of atrial fibrillation (AF) are an indication for pacemaker implantation. We evaluated sinus node function and clinical outcome in patients with prolonged sinus pauses on termination of arrhythmia who underwent ablation of paroxysmal AF. METHODS AND RESULTS:...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章

    doi:10.1161/01.CIR.0000090685.13169.07

    authors: Hocini M,Sanders P,Deisenhofer I,Jaïs P,Hsu LF,Scavée C,Weerasoriya R,Raybaud F,Macle L,Shah DC,Garrigue S,Le Metayer P,Clémenty J,Haïssaguerre M

    更新日期:2003-09-09 00:00:00

  • Long-term results of catheter ablation in paroxysmal atrial fibrillation: lessons from a 5-year follow-up.

    abstract:BACKGROUND:Paroxysmal atrial fibrillation (AF) naturally progresses toward chronic AF at an estimated rate of 15% to 30% over a 1- to 3-year period. Pulmonary vein (PV) isolation is increasingly performed for the treatment of drug-refractory paroxysmal AF. The long-term data on clinical outcome after circumferential PV...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.110.946806

    authors: Ouyang F,Tilz R,Chun J,Schmidt B,Wissner E,Zerm T,Neven K,Köktürk B,Konstantinidou M,Metzner A,Fuernkranz A,Kuck KH

    更新日期:2010-12-07 00:00:00

  • Clearance of tissue plasminogen activator (TPA) and TPA/plasminogen activator inhibitor type 1 (PAI-1) complex: relationship to elevated TPA antigen in patients with high PAI-1 activity levels.

    abstract:BACKGROUND:To evaluate the effect of plasminogen activator inhibitor type 1 (PAI-1) levels on the clearance of total tissue plasminogen activator (TPA) antigen, we studied the clearance of active TPA and TPA/PAI-1 complex in subjects with low (181+/-109 pmol/L; n=7) and high (1166+/-322 pmol/L; n=4) baseline active PAI...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.96.3.761

    authors: Chandler WL,Alessi MC,Aillaud MF,Henderson P,Vague P,Juhan-Vague I

    更新日期:1997-08-05 00:00:00

  • Randomized COMparison of platelet inhibition with abciximab, tiRofiban and eptifibatide during percutaneous coronary intervention in acute coronary syndromes: the COMPARE trial. Comparison Of Measurements of Platelet aggregation with Aggrastat, Reopro, an

    abstract:BACKGROUND:The relative anti-aggregatory effects of currently prescribed platelet glycoprotein IIb/IIIa receptor antagonists during and after percutaneous coronary intervention for acute coronary syndromes have not been established. METHODS AND RESULTS:We randomized 70 acute coronary syndrome patients undergoing percu...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1161/01.cir.0000029744.01096.1f

    authors: Batchelor WB,Tolleson TR,Huang Y,Larsen RL,Mantell RM,Dillard P,Davidian M,Zhang D,Cantor WJ,Sketch MH Jr,Ohman EM,Zidar JP,Gretler D,DiBattiste PM,Tcheng JE,Califf RM,Harrington RA

    更新日期:2002-09-17 00:00:00

  • Continuous 24-hour assessment of the neural regulation of systemic arterial pressure and RR variabilities in ambulant subjects.

    abstract::In this study, we tested the hypothesis that the neural control of circulation in humans undergoes continuous but in part predictable changes throughout the day and night. Dynamic 24-hour recordings were obtained in two groups of ambulant subjects. In 18 hospitalized patients free to move, direct high-fidelity arteria...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.81.2.537

    authors: Furlan R,Guzzetti S,Crivellaro W,Dassi S,Tinelli M,Baselli G,Cerutti S,Lombardi F,Pagani M,Malliani A

    更新日期:1990-02-01 00:00:00

  • Molecular imaging of innate immune cell function in transplant rejection.

    abstract:BACKGROUND:Clinical detection of transplant rejection by repeated endomyocardial biopsy requires catheterization and entails risks. Recently developed molecular and cellular imaging techniques that visualize macrophage host responses could provide a noninvasive alternative. Yet, which macrophage functions may provide u...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.108.796888

    authors: Christen T,Nahrendorf M,Wildgruber M,Swirski FK,Aikawa E,Waterman P,Shimizu K,Weissleder R,Libby P

    更新日期:2009-04-14 00:00:00

  • Enhanced activity of variant phospholipase C-delta1 protein (R257H) detected in patients with coronary artery spasm.

    abstract:BACKGROUND:We recently demonstrated that phospholipase C (PLC)-delta1 activity in cultured skin fibroblasts obtained from patients with coronary spastic angina (CSA) is enhanced. We tested the hypothesis that structural abnormality in PLC-delta1 isoform is a cause of the enhanced activity. METHODS AND RESULTS:Sequence...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.0000014613.36469.3f

    authors: Nakano T,Osanai T,Tomita H,Sekimata M,Homma Y,Okumura K

    更新日期:2002-04-30 00:00:00

  • Abnormalities of the extracellular degradation of collagen type I in essential hypertension.

    abstract:BACKGROUND:This study was designed to investigate whether collagen type I degradation is altered in patients with essential hypertension and whether this alteration could be related to disturbances in the serum matrix metalloproteinase pathway of collagen degradation. A second aim of the study was to assess whether som...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.98.6.535

    authors: Laviades C,Varo N,Fernández J,Mayor G,Gil MJ,Monreal I,Díez J

    更新日期:1998-08-11 00:00:00

  • The epidemiology of plasma high-density lipoprotein cholesterol levels. The Lipid Research Clinics Program Prevalence Study. Summary.

    abstract::Correlates of high-density lipoprotein (HDL) cholesterol levels were studied in 4756 white males and females ages 20-59 years examined during a population survey conducted by 10 North American Lipid Research Clinics. Multivariable analysis was used to assess the relation of social, demographic, physical and behavioral...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:

    authors: Heiss G,Johnson NJ,Reiland S,Davis CE,Tyroler HA

    更新日期:1980-11-01 00:00:00

  • Intermittent perfusion of ischemic myocardium. Possible mechanisms of protective effects on mechanical function in isolated rat heart.

    abstract::Intermittent restoration of coronary flow during ischemia reduced myocardial damage and improved recovery of function. The mechanisms of the protective effects of intermittent perfusion were investigated in isolated rat hearts. Ventricular function was assessed as the product of developed pressure (left ventricular sy...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.82.2.536

    authors: Tani M,Neely JR

    更新日期:1990-08-01 00:00:00

  • Quantitative coronary arteriography: estimation of dimensions, hemodynamic resistance, and atheroma mass of coronary artery lesions using the arteriogram and digital computation.

    abstract::More accurate characterization of coronary artery lesions is needed for evaluation of short and long-term interventions in coronary disease. A method of segmental artery analysis has been developed to maximize the information obtained from coronary arteriograms. Coronary lesions are traced from two projected, perpendi...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.55.2.329

    authors: Brown BG,Bolson E,Frimer M,Dodge HT

    更新日期:1977-02-01 00:00:00

  • Complete isolation of left atrium surrounding the pulmonary veins: new insights from the double-Lasso technique in paroxysmal atrial fibrillation.

    abstract:BACKGROUND:Paroxysmal atrial fibrillation (PAF) can be eliminated with continuous circular lesions (CCLs) around the pulmonary veins (PVs), but it is unclear whether all PVs are completely isolated. METHODS AND RESULTS:Forty-one patients with symptomatic PAF underwent 3D mapping, and all PV ostia were marked on the 3D...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000144459.37455.EE

    authors: Ouyang F,Bänsch D,Ernst S,Schaumann A,Hachiya H,Chen M,Chun J,Falk P,Khanedani A,Antz M,Kuck KH

    更新日期:2004-10-12 00:00:00

  • Long-term mitral valve replacement in young children. Influence of somatic growth on prosthetic valve adequacy.

    abstract::Long-term clinical and laboratory findings in three children who required mitral valve replacement below age four years are reported. In each instance a second valve replacement was necessary approximately 8 1/2 years after the initial one, following a two and one-half fold increase in body weight. Inadequate mitral v...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.57.5.981

    authors: Friedman S,Edmunds LH Jr,Cuaso CC

    更新日期:1978-05-01 00:00:00

  • Lack of association between the MEF2A gene and myocardial infarction.

    abstract:BACKGROUND:Coronary artery disease (CAD) and myocardial infarction (MI) are caused in part by genetic factors. Recently, the MEF2A gene was linked to MI/CAD in a single pedigree with autosomal-dominant pattern of inheritance. In addition, genetic variants within the gene have been associated with MI in case-control set...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.107.728485

    authors: Lieb W,Mayer B,König IR,Borwitzky I,Götz A,Kain S,Hengstenberg C,Linsel-Nitschke P,Fischer M,Döring A,Wichmann HE,Meitinger T,Kreutz R,Ziegler A,Schunkert H,Erdmann J

    更新日期:2008-01-15 00:00:00

  • Aminoguanidine prevents the decreased myocardial compliance produced by streptozotocin-induced diabetes mellitus in rats.

    abstract:BACKGROUND:A decreased cardiac compliance is a major feature of the cardiomyopathy of diabetes mellitus. Either an increase in the resistance afterload to the LV or an increase in collagen cross-linking induced by the formation of advanced glycosylation end products (AGEs) of collagen may be responsible for the stiff m...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.93.10.1905

    authors: Norton GR,Candy G,Woodiwiss AJ

    更新日期:1996-05-15 00:00:00

  • Molecular basis of autosomal dominant hypercholesterolemia: assessment in a large cohort of hypercholesterolemic children.

    abstract:BACKGROUND:Autosomal dominant hypercholesterolemia (ADH) is characterized by elevated low-density lipoprotein cholesterol levels and premature cardiovascular disease. Mutations in the genes encoding for low-density lipoprotein receptor (LDLR), apolipoprotein B (APOB), and proprotein convertase subtilisin/kexin 9 (PCSK9...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.110.979450

    authors: van der Graaf A,Avis HJ,Kusters DM,Vissers MN,Hutten BA,Defesche JC,Huijgen R,Fouchier SW,Wijburg FA,Kastelein JJ,Wiegman A

    更新日期:2011-03-22 00:00:00

  • Use of fresh decellularized allografts for pulmonary valve replacement may reduce the reoperation rate in children and young adults: early report.

    abstract:BACKGROUND:Degeneration of xenografts or homografts is a major cause for reoperation in young patients after pulmonary valve replacement. We present the early results of fresh decellularized pulmonary homografts (DPH) implantation compared with glutaraldehyde-fixed bovine jugular vein (BJV) and cryopreserved homografts...

    journal_title:Circulation

    pub_type: 杂志文章,多中心研究

    doi:10.1161/CIRCULATIONAHA.110.012161

    authors: Cebotari S,Tudorache I,Ciubotaru A,Boethig D,Sarikouch S,Goerler A,Lichtenberg A,Cheptanaru E,Barnaciuc S,Cazacu A,Maliga O,Repin O,Maniuc L,Breymann T,Haverich A

    更新日期:2011-09-13 00:00:00